• Korean Journal of Cleft Lip And Palate
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• v.8 no.1
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• pp.45-52
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• 2005

Velopharyngeal Insufficiency(VPI); the failure of velum, the lateral wall and the posterior pharyngeal wall to separate the nasal cavity from pharyngeal cavity during speech, can be caused by congenital conditions include cleft palate, submucous cleft palate and congenital palatal insufficiency. Speech problems of VPI are characterized by hypernasality, nasal air emission, increased nasal air flow and decreased intelligibility. These speech problems of VPI can be treated with the surgical procedure, the application of temporary prosthesis and speech therapy. Biofeedback technique with Nasometer is a speech treatment method of VPI that commonly used as one component of a comprehensive procedure for improvement of speech in patients with VPI. In this article describes a case of VPI treated by biofeedback technique with Nasometer; which showed satisfactory result in nasalance and formant analysis after the speech therapy during 9 months.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.22.1-22.4
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• 2015

Velopharyngeal dysfunction in cleft palate patients following the primary palate repair may result in nasal air emission, hypernasality, articulation disorder and poor intelligibility of speech. Among conservative treatment methods, speech aid prosthesis combined with speech therapy is widely used method. However because of its long time of treatment more than a year and low predictability, some clinicians prefer a surgical intervention. Thus, the purpose of this report was to increase an attention on the effectiveness of speech aid prosthesis by introducing a case that was successfully treated. In this clinical report, speech bulb reduction program with intensive speech therapy was applied for a patient with velopharyngeal dysfunction and it was rapidly treated by 5months which was unusually short period for speech aid therapy. Furthermore, advantages of pre-operative speech aid therapy were discussed.

• Speech Sciences
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• v.9 no.4
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• pp.49-58
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• 2002

This study was designed to examine the effects of vocal loudness on Nasalance scores in Korean vowels. One normal adult without 'hypemasality' produced 3 types of vowels (/i/, /a/, /u/) in 3 levels of loudness (60, 70, 80dB). Nasalance scores (%) and oral & nasal energy intensity (dB) were measured through NasalView system. These data were compared among 3 levels of loudness and among 3 types of vowels. The results were as follow: For all vowels, Nasalance scores significantly reduced when vocal loudness increased. Because the increases of oral energy intensity were larger than that of nasal energy intensity. For all levels of loudness, Nasalance scores significantly differed among vowel types (/i/>/a/>/u/).

• Phonetics and Speech Sciences
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• v.4 no.4
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• pp.79-86
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• 2012

In the two-band excitation (TBE) model, maximum voiced frequency (MVF) is the most important feature of the excitation parameter because the synthetic speech quality depends on MVF. Thus, this paper proposes an enhanced MVF estimation scheme based on the peak picking method. In the proposed scheme, the local peak and the peak lobe are picked from the spectrum of a linear predictive residual signal. The normalized distance between neighboring peak lobes is calculated and utilized as a feature to estimate MVF. Experimental results of both objective and subjective tests show that the proposed scheme improves synthetic speech quality compared with that of the conventional one.

• Phonetics and Speech Sciences
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• v.1 no.3
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• pp.123-132
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• 2009

This study investigates the differences in nasalance across handicap, gender, and vowels and the correlation between nasal energy and oral energy both of which are used to compute nasalance. For this study, 20 hearing-impaired adults and 20 normal hearing adults as a control group were asked to read 7 Korean vowels (/$\alpha$, $\Lambda$, o, u, ɯ, i, $\varepsilon$/). Subjects' readings were recorded by NasalView and analyzed by Praat. Results showed that the hearing impaired group (HL) has a significantly higher nasalance than the normal hearing group(NH), and that there was a significant positive correlation between nasal energy and oral energy. A higher nasalance of the hearing impaired group seems to be due to an improper velopharyngeal control which is caused by lack of a proper auditory feedback.

• Korean Journal of Cleft Lip And Palate
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• v.8 no.2
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• pp.95-105
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• 2005

Cleft lip and palate is a congenital deformity which needs a professional and consistent management from the birth and along with the physical growth of patients. The patients with cleft lip and palate can have general speech problems with resonance disorders, voice disorders and articulation disorders after the successful primary surgical management and the physical growth. Speech problems of Cleft lip and palate are characterized hypernasality, nasal air emission, increased nasal air flow, and aberrant speech marks which decrease intelligibility. These speech problems of cleft lip and palate can be treated with the secondary surgical procedure, the application of temporary prosthesis and the effective and well-timed speech therapy. The speech and language problems of cleft lip and palate, the general procedures and schedules of the speech assessment and therapy based on the multidisciplinary approach are introduced for the patients with cleft lip and palate, their family and the other members of the cleft palate treatment team.

• Journal of Yeungnam Medical Science
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• v.8 no.1
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• pp.246-251
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• 1991

In 1962, a case of "generalized skeletal dysplasia with multiple anomalies" was reported by Taybi as a new clinical syndrome. The most characteristic features of the syndrome seemed to be hearing loss, cleft palate and peculiar digital anomalies, so, the syndrome designated as otopalatodigital syndrome by Dudding, et al. Recently, The authors have experienced a case OPD syndrome who visited Yeungnam University Hospital with the chief complaint of hypernasality, and underwent pharyngoplasty for correction of VPI. We present here a new case and review the literature on the subject.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.4
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• pp.721-728
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• 2004

Velopharyngeal closure is a sphincter mechanism between the activities of the soft palate, lateral pharyngeal wall and the posterior pharyngeal wall, which divides the oral and nasal cavity. It participates in physiological activities such as swallowing, breathing and speech. It is called a velopharyngeal dysfunction when this mechanism malfunctions. The causes of this dysfunction are defects in (1) length, function, posture of the soft palate, (2) depth and width of the nasopharynx and (3) activity of the posterior and lateral pharyngeal wall. The purposes of this study are to analyze the nasopharynx of cleft palate patients using cephalometry and to evaluate the degree of hypernasality using nasometry to find its relationship with velopharyngeal dysfunction. The following results were obtained : 1. In cephalometry, there were significant differences in soft palate length, soft palate thickness, nasopharyngeal depth, nasopharyngeal area, and adequate ratio between two groups. 2. In nasometry, there were significant differences between two groups in vowel /o/ and sentences including oral consonants. 3. In cleft palate patients, though no general correlation was found between Anatomic VPI and nasalance scores, vowel /i/ and sentences including oral consonants were slightly correlated. In conclusion, cephalometry and nasometer results were significantly different between the two groups. Though in the cleft palate group, Anatomic VPI and nasalance scores, which are indices for velopharyngeal closure, excluding the vowel /i/ and sentences including oral consonants show generally no significance.

• Archives of Plastic Surgery
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• v.44 no.3
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• pp.202-209
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• 2017

Background No consensus exists on the optimal treatment protocol for orofacial clefts or the optimal timing of cleft palate closure. This study investigated factors influencing speech outcomes after two-stage palate repair in adults with a non-syndromal complete unilateral cleft lip and palate (UCLP). Methods This was a retrospective analysis of adult patients with a UCLP who underwent two-stage palate closure and were treated at our tertiary cleft centre. Patients ${\geq}17$ years of age were invited for a final speech assessment. Their medical history was obtained from their medical files, and speech outcomes were assessed by a speech pathologist during the follow-up consultation. Results Forty-eight patients were included in the analysis, with a mean age of 21 years (standard deviation, 3.4 years). Their mean age at the time of hard and soft palate closure was 3 years and 8.0 months, respectively. In 40% of the patients, a pharyngoplasty was performed. On a 5-point intelligibility scale, 84.4% received a score of 1 or 2; meaning that their speech was intelligible. We observed a significant correlation between intelligibility scores and the incidence of articulation errors (P<0.001). In total, 36% showed mild to moderate hypernasality during the speech assessment, and 11%-17% of the patients exhibited increased nasalance scores, assessed through nasometry. Conclusions The present study describes long-term speech outcomes after two-stage palatoplasty with hard palate closure at a mean age of 3 years old. We observed moderate long-term intelligibility scores, a relatively high incidence of persistent hypernasality, and a high pharyngoplasty incidence.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.18 no.1
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• pp.39-43
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• 2007

Background and Objectives: There are few studies reported that specifically examine the phonetic characteristics and voice handicap index (VHI) in patients with Allergic Rhinitis. This study was designed to examine phonetic characteristics and VHI in adult patients with allergic rhinitis. Materials and Methods: Forty-two male patients diagnosed as allergic rhinitis were given skin-prick test and others, aged from 20 to 56 years, and were compared with a 16 male control group with no pathology and in the same age group. The VHI was used to measure the changes of patient's perception. Acoustic and aerodynamic analysis test were done, and a nasalance test performed to measure rabbit, baby, and mother passage. Acoustic rhionometry (AR) was performed to evaluate nasal volume and nasal crosssectional area. Statistical analysis was done using independent sample t-test. Results: VHI showed significantly different score in the studied group, higher than that of control group. AR graph showed that there was no significant differences of nasal volume and nasal cross-sectional area. The Shimmer and SFF value in the group of allergic patients were higher than in the control group. MPT value in the group of allergic patients was lower than in the control group. Nasalance in allergic patients showed hypernasality all passage. Conclusion: We suggest that patients with allergic rhinitis have considerable voice problems. Most of them have hypernasality, which may be a compensatory mechanism by nasal obstruction.